Thursday, February 12, 2015

Lili's book review for the day

I'm very much enjoying reading Ben Goldacre's latest book I Think You'll Find It's a Bit More Complicated Than That, even though most of it is material from Goldacre's newspaper column in the Guardian, some of it quite old. I love the way the book kicks off with a piece that asks a serious question about the scientific credibility of the loud, emphatic and often-repeated pronouncements of Professor Susan Greenfield about the supposed dire effects of computer use on the brain development of children. With the greatest politeness Goldacre places Greenfield's controversial idea outside the arena of credible scientific debate. I am so fed up with seeing that bigmouth in heels popping up on Australian television and Australian speaking engagements, so it is gratifying to see a good hard questioning of this public nuisance given a position of prominence in Goldacre's book. I can only hope that people from the Australian Broadcasting Corporation might come across it. Another publicity-seeking English academic who has been a target of my attentions at this blog is discussed in the book, in an investigation of a "bizarre" and embarassing matter concerning autism and a media report that appeared to go against the consensus of science. Can you guess who that English autism researcher might be? Yes, in this book Goldacre writes about Baroness Greenfield and also Professor Baron-Cohen. 

I'm pleased to read just about anything Goldacre writes, because he is a journalist and writer in an entirely different class than most. There are plenty of people (mostly men) out there who like to think of themselves as hard-headed skeptics or rationalists, but their critical scrutiny has definite limits. They love to ridicule the usual targets of the scientifically smug: new agers, homeopathy, anti-vaccination campaigners, but they show no interest or awareness of the many crises of credibility within conventional medicine, and they love to quote textbook accounts of how they believe science works, without acknowledging the many scandals and fundamental problems that are coming to light in academic research, including conflicts of interest, research fraud and failures of peer review. If these people were true skeptics, they would see and acknowledge problems wherever mere humans make claims to know how to heal and to know how diseases and human bodies work. Ben Goldacre comes fairly close to meeting my high standard of what a true skeptic should be, and he's not just an armchair knocker, he is a qualified doctor and academic with a high-powered career, so he certainly does not argue from ignorance. Goldacre is great and it is a unique service to humanity that he writes books, a blog and newspaper columns, but in my eyes he could definitely do better.

I do not recall ever seeing Dr Goldacre questioning the labels and the basic concepts in medicine and psychiatry that are so controversial among elite academic and medical researchers and non-professionals alike. Researchers such as Gordon Rugg and Sue Gerrard, as well as the man in the street, have questioned the value of "autism" as a diagnosis or a way of categorizing people, while Goldacre writes about autism in much the same way as any other medico would. Countless critics such as former politician and teacher Dr Martin Whitely, and the bloke in the street, have questioned the application of ADHD as a label for children, but I don't recall ever seeing Goldacre go down this path in his writing. Professor Peter Gotzsche, who is no less than a co-founder of the Cochrane Collaboration shares Goldacre's serious concern about the quality of research and government regulation pertaining to commonly-used prescription drugs, but Gotzsche takes an important step beyond Goldacre's campaigning in his assertion that mental illness is over-diagnosed, a belief that many people with no medical education would agree with, based on their common sense and personal observations alone. A passionate advocate of evidence-based medicine and careful research, Goldacre's focus is exceedingly sharp but disappointingly short-sighted. He's all about designing the study properly and reviewing the literature to standards of excellence, but I don't see him asking too many questions about the assumptions and definitions behind the study's premise. All the same, his books are 100% less frustrating to read than the work of all of those "skeptics" whose main motivation to write or speak appears to be a misogynistic joy in taking the mickey out of harmless old ladies who believe in Reiki healing. Dr Goldacre's humanity and civility shine through all of his work, and this alone is a pleasure to read. 


Anonymous said...

Thanks for the recommendation! I've just finished reading the book, and thoroughly enjoyed it. A good reminder of just how much complete rubbish there is out there.


Lili Marlene said...

Glad you liked it Tomas!

What would the world look like if there were more folks like Goldacre, and they had some clout, I wonder. There's a chapter in the book intended to educate educators about evidence-based practice. Considering that I've only partly successfully tried to explain to qualified librarians working in public libraries around these parts what the Cochrane Library is and why it is important and useful and why they should promote it to their readers, the idea of our local cup-cake munching teachers and school principals conceiving and conducting randomized controlled trials or systematic literature searches looks like science fiction to my eyes. I guess you've got to have a dream, to make a dream come true..........